Pelvic Organ Prolapse

This condition usually starts with symptoms of heaviness in the vagina but is not usually painful. It can affect emptying of bladder, bowel function, etc. Prolapse occurs when a pelvic organ has poor structural stability and falls into the vagina and sometimes comes through the vaginal opening. It is aggravated by standing and relieved by lying down. This can happen with extreme intra-abdominal pressure, after childbirth, after a hysterectomy or any surgeries removing any pelvic organs. The types of prolapse are:

o Cystocele – when the bladder prolapses into the vagina;

o Urethrocele – when the urethra falls into the anterior vaginal wall;

o Uterine Prolapse – When the uterus prolapses into the vagina;

o Vaginal Vault Prolapse – After a hysterectomy the top of the vagina can fall downwards into the vagina;

o Enterocele – when the small bowel prolapses into the vagina; and

o Rectocele – when the rectum prolapses into the vagina.

There are different grades of prolapse which essentially means how far the organ has fallen. Grade 4 prolapse is the most severe and means the pelvic organ rests outside the entry of the vagina and can rub on inner legs and underwear.

Pelvic floor physiotherapy can provide exercises and education on how to treat prolapse symptomatically. If physiotherapy is unsuccessful with your problems, surgery may be necessary.